Well-being remains a top concern nearly 3 years into pandemic
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I continue to follow the COVID-19 statistics on the Worldometer website.
As of Oct. 15, 2022, there have been 631 million cases and 6.5 million deaths reported by the 230 countries and entities sharing data. These numbers are certainly less than the actual volumes. The denominator for those reporting cases is about 6 billion to 7 billion, so at least one in 10 humans in the world has been infected since the first cases were discovered in Wuhan, China, in January 2020.
In the United States, 99 million cases have been reported in a population of 332 million, for an incidence near 30%. This incidence is higher than many reporting countries, likely because of more accurate data. Death has been the outcome for 1.1 million Americans, a 1.1% average incidence over the past 31 months, similar to the global data. These unexpected deaths have caused the life expectancy in America to decline for the first time in decades.
When I look at the Worldometer 7-day moving averages, there have been six spikes of reported infections over the last 2.6 years. The worst of these spikes occurred in 2021 and 2022 in mid-winter during January. We are now entering our third winter season in the COVID-19 era and can anticipate another mid-winter spike, so extra caution, especially for those at high risk, which includes many of our more senior patients and colleagues, is appropriate.
Fortunately, a high rate of vaccination or previous infection has enhanced most Americans’ resistance to the virus, and the current strains of coronavirus are less virulent. These two reasons, along with better therapy, have caused the hospitalization and death rate to decline significantly. On the negative side, we suffered case volume spikes the last two winters, and in January 2022, we hit 900,000 new cases a day. At present, we are reporting about 15,000 cases a day in the U.S., but this will certainly rise this winter and likely peak in January 2023.
Ophthalmology was the most affected specialty in medicine in spring 2020 with a shutdown in all but emergency clinic and surgical cases. Cataract surgery plummeted in 1 month nearly 96%. This near-total shutdown of elective eye care was fortunately short lived, but clinic and case volumes nationwide have not yet retuned to pre-pandemic levels.
In many cases, this delay in clinic and surgical case volume recovery is related to challenges in recruiting adequate staff to meet patient demand. In other cases, especially in large institutions, patient access is still restricted.
An unexpected so-called black swan event like the COVID-19 pandemic has many consequences, some good but many negative. Several positive outcomes of ophthalmologists’ response to the pandemic are noted in the accompanying cover story, including enhanced telehealth, growth in digital access, improvements in online learning, better home health care monitoring devices, improved in-office safety policies, increased attention to sustainability, more task delegation to care extenders, and increased focus on eye care professional and staff psychological well-being.
A few personal thoughts on the last observation, psychological well-being. Published surveys in every part of the world confirm that individuals have a reduced feeling of well-being and an increased fear about their future. Most economies, including the U.S., are challenged with unexpected inflation and a downward trend in asset values, whether they be real estate, stocks, bonds or even cryptocurrencies. A global recession is either here or eminent, along with a global drought, increased international conflict and potential famine in less well-developed countries. The Consumer Confidence Index, which is a measure of individual optimism, has fallen from 135 in 2019 to 95 today, a slight increase from the 2021 and 2022 lows near 85. The University of Michigan Consumer Sentiment Index, a measure of consumer confidence in the economy, has crashed from near 100 before the pandemic to 60 today. The average American is stressed and pessimistic.
I believe it will take at least another 24 months to recover our pre-pandemic perceived and actual well-being in the U.S., and perhaps longer elsewhere. During these difficult times, the support of family, friends and colleagues is critically important. As physicians, it is our duty to watch for signs of stress in our patients, partners and family members and provide support when indicated.
On a recent father-son weekend retreat with my former fellow John Berdahl, MD, he shared a thought from his 97-year-old amazingly talented and resilient grandmother, Annabelle Loken, RN. Her wise and timely advice: “Enjoy when you can. Endure when you can’t.” Now is a time when perseverance, resilience and goodwill are required, especially from those tasked with leadership.
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